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[Breathlessness of the elderly and its managements]
1Second Department of Internal Medicine, School of Medicine, University of Toho.
Abstract:
It is certainly difficult to understand the clinical significance of dyspnea or breathlessness among the elderly, though this symptom is quite routine. Setting a conjugate of the dyspnea index as an indicator of ventilatory reserve ratio, its distribution was tested along an age abscissa upon the twenty senile dyspnea and demonstrated almost all of them below the 30% level. Their arterial blood oxygen tensions were grouped onto the severity rank of dyspnea, clarifying that some senile lived of no complaint by the blood oxygen tensions within the range of pulmonary insufficiency, despite there some reluctant by the normal blood gas tensions. In order to comprehend this evidence, the dyspnea was dissected into several raising factors, each of which was examined the manner how a set of organs in the respiratory system of the elderly to be concerned under aging effects and to be detected in measurement. Respiratory center drive behaves in response to the efficacy of ventilation apparatus, so in resting state it supports by minimum activity without sensation of breathing difficulty, but at needs it works more even in dyspnea, the sensation of which deepens less itself together with increment of oxygen consumption. Considerable causes of this symptom for the senile may be due to hyperventilation syndrome, lung embolism after bone fracture, diabetic pulmonary capillopathy and hypophosphatemia. The treatments of senile dyspnea shall require the exact estimation of causal seriousness and not only attain improvement of pulmonary impairments and its accessory setups but also psychophysical rehabilitations upon rational nutrient preservation.